Multiple Myeloma an incurable disease, but I have spent the last 25 years in remission using a blend of conventional oncology and evidence-based nutrition, supplementation, and lifestyle therapies from peer-reviewed studies that your oncologist probably hasn't told you about.
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I was diagnosed with multiple myeloma (MM) in early 1994 and underwent a hematopoietic stem cell transplant (ASCT) in December of 1995. The years following my ASCT have been filled with long-term and late stage side effects caused by my ASCT.
While an autologous stem cell transplant has a place in the treatment of multiple myeloma, painful experience has taught me that this aggressive, toxic therapy can damage the patient’s brain, heart, endocrine system, eyes, just about all his/her organs.
Your oncologist probably won’t explain to you all of the life alterning side effects of ASCT. In short, an ASCT should not be used unless it is absolutely necessary.
In other words, if newly diagnosed MM patients can achieve minimal residual disease (negative) status, or achieve a solid response to his/her induction therapy, an ASCT might not result in longer overall survival on average.
Why would anyone undergo more aggressive, toxic chemotherapy if he/she wasn’t sure of achieving a longer overall survival (length of life)?
There are two sure events that should cause the newly diagnosed MM survivor and caregiver to think long and hard about having an ASCT following induction therapy. And those two events are
solid response to your induction therapy-solid meaning VGPR, CR, sCr, MRD pos and MRD neg.-
experiencing extensive side effects from your induction therapy- if you have to live through skin pain, anemia, nausea, etc. there is a good chance that you are sensitive to chemo and therefore will be sensitive to aggressive, highly toxic therapies that make up the ASCT chemotherapy.
Have you been diagnosed with multiple myeloma? Has your oncologist recommended an ASCT? What was your stage and symptoms at diagnosis? What are your goals?
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“However, hematopoietic stem cell transplantation (HSCT) survivors are at risk of developing long-term complications, such as
These complications have a direct impact on the morbidity and mortality experienced by HSCT survivors. Two-thirds of HSCT survivors develop at least one chronic health condition; while a fifth develop severe or life-threatening conditions.
HSCT patients who have survived for at least 5 years post-transplantation are at a fourfold to ninefold increased risk of late mortality for as long as 30 years from HSCT, producing an estimated 30% lower life expectancy compared with the general population…”
“In this study, we demonstrate that a significant proportion of patients undergoing HCT report PTSD and depression symptoms at six months post-HCT, further illustrating the substantial psychological burden endured by this population…”
“In this prospective study we investigated early (at 3 months) and late (at 12 months) endocrine dysfunctions in 95 consecutive autologous stem-cell transplant recipients (47 men and 48 women) aged 16 to 55 years. The functions of the hypothalamic-pituitary-gonadal/thyroid/adrenal/somatotroph axis were evaluated…
This study documents frequent endocrine disorders during the first year after autologous stem-cell transplant. Despite a tendency to improve, in more than half of the cases, the complications persisted for more than 1 year. Therefore, to diagnose and correct early and late endocrine dysfunctions, endocrine screening is required during the first year in all patients undergoing autografting.”
” Patients who have undergone HDT and AHSCT are at significant risk for developing a second malignancy and should receive indefinite follow-up…”
“Background: The main goal of this post hoc analysis of the Collaboration to Collect Autologous Transplant Outcomes in Lymphoma and Myeloma (CALM) study was to evaluate the rate of
occurring after ASCT in patients with multiple myeloma (MM).
Methods: The analysis included all patients with MM from the CALM study who underwent ≥1 ASCT. The primary endpoint of the analysis was to determine the rate of infectious and non-infectious complications after ASCT and to compare them in three time periods: 0–100 days, 101 days–1 year, and >1 year after the first transplant.
Results: The analysis included a total of 3552 patients followed up for a median of 56.7 months (range 0.4–108.1). Complication rates decreased with the time from ASCT with 24.85 cases per 100 patient-years from day 0 to 100 days after the transplant, and <2.31 cases per 100 patient-years from the 101st day.
At 100 days after ASC T, 45.7% of patients had complications, with infectious events being twice as frequent as non-infectious complications. Bacterial infections (6.5 cases per 100 patient-years, 95% CI: 6.1–7.0) and gastrointestinal complications (4.7 cases per 100 patient-years, 95% CI: 4.3–5.1) were the most common early events.
The pattern of complications changed with time from ASCT. The presence of complications after ASCT was not associated with overall survival.
Conclusions: Our data provide a solid basis for comparing ASCT-related complications to those caused by emerging treatments in multiple myeloma, such as CAR T-cell therapy and other immunotherapies.